End-stage renal disease (ESRD) is increasing in incidence and prevalence every year with African Americans disproportionately affected. Patients with ESRD experience many metabolic abnormalities including abnormal calcium, phosphate, bicarbonate and parathyroid hormone (PTH)levels. African Americans are known to have higher levels of parathyroid hormone than Caucasians. It is unclear whether this elevation is of clinical significance and whether there should be different parathyroid hormone goals for African Americans versus Caucasian patients. Dr. Melamed plans to analyze data from the Choices for Healthy Outcomes in Caring for ESRD (CHOICE), an NIDDK-funded study, to investigate the bone disease parameters in African Americans and Caucasians. She intends to obtain data regarding hospital admissions for hip fractures and cardiovascular morbidity and mortality and investigate associations with PTH levels and vitamin D replacement therapy. In addition, in order to investigate determinants of lower bone mineral density in chronic kidney disease she plans to analyze data on inflammation and acidosis from the Third national Health and Nutrition Examination Survey.